Individual provider Active NPI

Muthu Deepak Vignesh Bhaskaran, M.D.

  • Neurocritical Care Physician
  • Atlanta, GA
National Provider Identifier
1548552011
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
73946 Issued in GA
Practice address
285 Boulevard NE Ste 415
Atlanta, GA 30312-4210
Phone
(404) 265-4400
Fax
(404) 265-5542
NPI assigned
May 3, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084A2900X 73946 GA Primary
Neurology Physician 2084N0400X 73946 GA

Addresses

Primary practice location

285 Boulevard NE Ste 415
Atlanta, GA 30312-4210

Mailing address

285 Boulevard, NE St415
Atlanta, GA 30312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170823002604 GA Practitioner - Neurology 7719126416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2912

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73946GAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Neurology CurrentSince Aug 1, 2017 Accepting new patients
Wellstar Medical Group, LLC Single Specialty CurrentSince Aug 1, 2017 Accepting new patients
Wellstar Medical Group, LLC Single Specialty Current Accepting new patients

Locations

285 Boulevard NE
Ste 415
Atlanta, GA 30312
Phone (404) 265-4400

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

677 Church St NE
Ste 100
Marietta, GA 30060
Phone (470) 793-8585

Interoperability endpoints

  • Direct secure messaging: mbhaskaran141828@directwellstar.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1548552011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 BOULEVARD, NE ST415",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 BOULEVARD NE STE 415",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303124210",
            "telephone_number": "404-265-4400",
            "fax_number": "404-265-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHASKARAN",
        "first_name": "MUTHU",
        "middle_name": "DEEPAK VIGNESH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-03",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "GA",
            "license": "73946",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "73946",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.